Is loneliness a predictor of the modern geriatric giants? Analysis from the survey of health, ageing, and retirement in Europe

  • Maria Giné-Garriga
    Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain

    Department of Physiotherapy, Faculty of Health Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
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  • Javier Jerez-Roig
    Corresponding author at: Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Vic, Spain.
    Research Group on Methodology, Methods, Models and Outcome of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain
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  • Laura Coll-Planas
    Research Group on Methodology, Methods, Models and Outcome of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain

    Fundació Salut i Envelliment (Foundation on Health and Ageing), Universitat Autònoma de Barcelona, Barcelona, Spain
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  • Dawn A. Skelton
    Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
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  • Marco Inzitari
    Intermediate Care Hospital, Parc Sanitari Pere Virgili, Avinguda de Vallcarca 169-205, 08023, Barcelona, Spain

    RE-FiT Barcelona Research Group, Vall d’Hebrón Institute of Research (VHIR), Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
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  • Joanne Booth
    Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
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  • Dyego L.B. Souza
    Research Group on Methodology, Methods, Models and Outcome of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain

    Federal University of Rio Grande do Norte, Department of Collective Health, Postgraduate Programme in Collective Health, Natal, Brazil
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      • Loneliness is a risk factor for physical inactivity, cognitive impairment and fatigue in older adults.
      • Anorexia of ageing and sarcopenia were not predicted by loneliness over the 2-year period.
      • These conclusions should inform the design of interventions to target loneliness in the older adult population.



      The modern Geriatric Giants have evolved to encompass four new syndromes, of frailty (linked to fatigue and physical inactivity), sarcopenia, anorexia of ageing, and cognitive impairment. In parallel, loneliness has been established as a risk factor for adverse mental and physical health outcomes among older adults.


      To analyse loneliness as a predictor of the modern Geriatric Giants in European older adults, using a longitudinal design of nationally representative data.


      Longitudinal population-based cohort study.


      Data from countries that participated in waves 5 and 6 of the Survey of Health, Ageing, and Retirement in Europe project. The sizes of the subsamples analysed ranged from 17,742 for physical inactivity to 24,524 for anorexia of ageing.


      Loneliness (measured from wave 5) was the independent variable of interest. The dependent variables were incidence of fatigue, physical inactivity, sarcopenia, anorexia of ageing, and cognitive impairment from wave 5 (baseline) to wave 6. Poisson regression models were used for multivariable analysis, obtaining Relative Risk (RR) and 95 % confidence intervals (CI).


      The prevalence of loneliness ranged from 9.2%–12.4% at wave 5. The 2-year incidence of fatigue was 16 % (95 % CI: 15.5–16.5), physical inactivity 9.8 % (95 % CI: 9.4–10.3), sarcopenia 5.6 % (95 % CI: 5.3–5.9), anorexia of aging 5.4 % (95 % CI: 5.1–5.7), and cognitive impairment 10.3 % (95 % CI: 9.9–10.8). The multivariable analysis showed that loneliness was a predictive factor for fatigue (30 %, CI: 17–45 % higher risk), physical inactivity (24 %, CI: 7–43 % higher risk) and cognitive impairment (26 %, CI: 9–46 % higher risk), adjusted by age, sex, number of chronic diseases, education level, region and depression.


      Loneliness is an independent risk factor for fatigue, physical inactivity, and cognitive impairment in older adults. The incidence of anorexia of ageing and sarcopenia was not associated with loneliness over the 2-year observation period.


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